Provider Demographics
NPI:1164789053
Name:ARRINGTON, SHENELL RENE (GNA/CNA)
Entity Type:Individual
Prefix:MRS
First Name:SHENELL
Middle Name:RENE
Last Name:ARRINGTON
Suffix:
Gender:F
Credentials:GNA/CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:352 AHERN DR
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:21040-3400
Mailing Address - Country:US
Mailing Address - Phone:410-538-6440
Mailing Address - Fax:410-538-6440
Practice Address - Street 1:352 AHERN DR
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:MD
Practice Address - Zip Code:21040-3400
Practice Address - Country:US
Practice Address - Phone:410-538-6440
Practice Address - Fax:410-538-6440
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-16
Last Update Date:2012-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12AL0125-E3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD464403400Medicaid